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Oral Medicine BDS4 > Salivary gland disease, neoplasm and malignancy > Flashcards

Salivary gland disease, neoplasm and malignancy Flashcards

1
Q

What type of glands are saliva glands?

A

EXOCRINE glands

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2
Q

What are the three main functions of saliva?

A
  • Lubrication
  • Innate immunity
  • Facilitating chewing and swallowing
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3
Q

What controls saliva secretion?

A

The autonomic nervous system

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4
Q

What are the two pathways involved in saliva secretion control?

A
  • Sympathetic
  • Parasympathetic
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5
Q

What effect does the sympathetic pathway have on salivary flow?

A

Decreases salivary flow

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6
Q

What effect does the parasympathetic pathway have on salivary flow?

A

Increases salivary flow

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7
Q

What are the major salivary glands?

A
  • Parotid Glands
  • Submandibular Glands
  • Sublingual Glands
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8
Q

What percentage of saliva is produced by the parotid gland?

A

20-25%

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9
Q

What is the duct associated with the parotid gland?

A

Stensen’s Duct

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10
Q

What is the duct associated with the submandibular gland?

A

Wharton’s Duct

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11
Q

What percentage of saliva is produced by the submandibular gland?

A

65-75%

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12
Q

What percentage of saliva is produced by the sublingual gland?

A

7-8%

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13
Q

How many minor salivary glands are there approximately?

A

800 – 1000

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14
Q

What are some causes of lump or swelling in saliva glands?

A
  • Obstruction (Obstructive Sialadenitis)
  • Sialadenitis
  • Sialosis
  • Neoplasm
  • Trauma and fluid
  • Solid deposits
  • Intra-gland lymph node swelling
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15
Q

What is Obstructive Sialadenitis commonly referred to as?

A

Mealtime syndrome

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16
Q

What are the symptoms of Obstructive Sialadenitis?

A
  • Intermittent swelling
  • Usually unilateral
  • May have inflammation
  • Usually painful but can be painless
  • Associated with mealtimes
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17
Q

What is the most common gland affected by Obstructive Sialadenitis?

A

Submandibular gland

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18
Q

What are common causes of Obstructive Sialadenitis?

A
  • Sialoliths
  • Stricture in the salivary duct
  • Salivary duct oedema
  • Neoplasm blocking the duct
  • Mucous plug
19
Q

What is Sialadenitis?

A

Inflammation of the salivary glands

20
Q

What virus causes Acute Viral Sialadenitis?

21
Q

What are common symptoms of Acute Bacterial Sialadenitis?

A
  • Painful swelling
  • Erythema
  • Pus from duct
  • Trismus
  • Pyrexia
  • Cervical lymphadenopathy
22
Q

What are some risk factors for Acute Bacterial Sialadenitis?

A
  • Dehydration
  • Radiotherapy
  • Duct obstructions
  • Sjogren’s Disease
  • Poor oral hygiene
  • Smoking
23
Q

What is Sialosis?

A

Benign and bilateral salivary gland hyperplasia

24
Q

What are some associated conditions with Sialosis?

A
  • Alcohol excess
  • Diabetes
  • Acromegaly
  • Malnutrition
  • Anorexia
  • Bulimia
  • Cystic fibrosis
  • Cirrhosis
25
What is a mucocele?
Cystic lesions of the minor salivary glands
26
Where are mucoceles commonly found?
* Lower labial mucosa * Floor of mouth * Upper lip (less common)
27
What are common symptoms associated with coidosis?
* Uveitis * Macroglossia * Peripheral neuropathy * Bruising/purpura * Peripheral oedema * GI symptoms * Fatigue * Weight loss (associated with amyloidosis) ## Footnote Coidosis may present with a variety of systemic symptoms impacting multiple organ systems.
28
What are mucocele cystic lesions commonly found?
* Lower labial mucosa * Floor of mouth * Upper lip (higher risk of malignancy) ## Footnote Upper lip lesions should be treated as neoplasms until proven otherwise due to their malignancy risk.
29
What is the appearance of a mucocele?
* Fluctuant * Blue swelling * Swelling ## Footnote The appearance is characteristic and can help in clinical diagnosis.
30
What are the two types of mucoceles?
* Mucous Extravasation (90%) * Mucous retention cyst (10%) ## Footnote Mucous Extravasation is caused by trauma, while Mucous retention cyst occurs due to saliva retention.
31
What is the primary cause of Mucous Extravasation?
Trauma to the minor salivary duct ## Footnote This type of mucocele is not lined by epithelium and is not a true cyst.
32
What are common management options for mucoceles?
* No treatment (unlikely to resolve) * Excision of lesion by Oral Surgery ## Footnote Excision is preferred, but recurrence rates are high, and there is a risk of damaging neighboring structures.
33
What is necrotising sialometaplasia?
Swelling which results in ulceration ## Footnote It is usually painless and self-healing within a couple of weeks.
34
What is the common aetiology of necrotising sialometaplasia?
Probably small vessel infarction/ischaemia ## Footnote It is more common among smokers and those with trauma or local anesthetic use to the palate.
35
What are the clinical features of salivary neoplasms?
* Unilateral swelling * Red flags: Facial palsy, sensory loss, pain, difficulty swallowing, trismus, rapid growth ## Footnote These features may indicate malignancy and necessitate urgent referral.
36
What is the most common salivary gland tumor?
Pleomorphic adenoma (PSA) ## Footnote Most salivary neoplasms are benign, but malignancy is more common in minor salivary glands.
37
Which salivary gland neoplasms are benign?
* Pleomorphic Adenoma (PSA) * Warthin Tumour * Myoepithelioma * Basal cell adenoma * Oncosytoma * Canalicular adenoma ## Footnote These tumors typically present as unilateral parotid swellings.
38
Which salivary gland neoplasms are malignant?
* Acinic Cell Carcinoma * Mucoepidermoid carcinoma * Adenoid cystic carcinoma * Polymorphous low grade adenocarcinoma * Epithelial myoepithelial carcinoma * Carcinoma ex-PSA ## Footnote Malignancy rates are higher in minor salivary glands.
39
What are the associations with salivary gland neoplasms?
* Smoking * Infections (EBV, simian virus 40, herpes virus) * Plumbing, manufacturing, mineral exposure * Ionizing radiation * Genetics (e.g., altered expression of PLAG1, P53) ## Footnote These associations can help identify at-risk populations.
40
What is the management approach for benign salivary neoplasms?
Surgical excision if alone and benign ## Footnote The main risk during surgery is facial nerve injury.
41
What is a characteristic of Warthin's Tumour?
Associated with smoking and accounts for 10% of salivary neoplasms ## Footnote It is benign and can occur bilaterally in 5% of cases.
42
What is a defining feature of Adenoid Cystic Carcinoma?
Slow growing, malignant, spreads perineurally ## Footnote It is rare but can metastasize, making it a significant concern.
43
What is the most common childhood salivary neoplasm?
Mucoepidermoid Carcinoma ## Footnote This low-grade malignancy is more common in minor salivary glands.
44
What is the typical presentation of pleomorphic adenoma (PSA)?
Arises from duct epithelium, slow growing, usually benign ## Footnote Recurrence is low at about 3% within 5 years after excision.

Oral Medicine BDS4 (3 decks)

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